Dielectical Behavior Training
The Christian Counseling Center DBT Program Description
The Christian Counseling Center (CCC) now offers Dialectical Behavior Therapy (DBT), an evidence supported treatment that was developed by Marsha Linehan and her colleagues to treat Borderline Personality Disorder (BPD). DBT treats problems in emotion regulation, impulsive and sometimes life-threatening behaviors, relationship chaos, and rigid thinking patterns.
CCC offers a 24-week DBT program that includes weekly individual DBT sessions, skills training group, phone consultation, and a therapist consultation group.
Individual Therapy: Through a combination of dialectical, validation, and problem-solving strategies, individual therapy helps clients to inhibit maladaptive, mood-dependent behaviors and replace them with more skillful responses.
Skills Training: A skills training group combines lecture, discussion and practice exercises to develop and refine skills in non-judgmental, present moment awareness and acceptance, distress tolerance, emotion regulation, interpersonal effectiveness, problem-solving and relapse prevention.
Telephone Consultation: Through telephone contact, clients receive "coaching" in how to apply skills in their everyday lives. Telephone consultation can be especially helpful to clients when they find themselves in difficult situations and need assistance in putting the skills to work.
Consultation Team: Consultation group is for DBT practitioners. In a non-judgmental and validating environment, consultation group problem-solve difficulties that interfere with clients' progress in treatment and help keep each other within a dialectical framework.
DBT INTRODUCTION
Dialectical Behavior Therapy (DBT) is a research-supported treatment which combines cognitive-behavioral theory with principles and practices of acceptance and validation. Developed by Dr. Marsha Linehan and her colleagues at the University of Washington, DBT addresses problems in regulating emotions, behavior, and thinking.
Emotions
• Heightened emotional sensitivity
• Quick and intense emotional reactions
• Slow return to baseline (normal) mood
• Chronic problems with depression, anxiety, anger or anger expression
Behavior
• Repeated suicide threats or attempts
• Self-harm behavior such as cutting and burning
• Problematic interpersonal behaviors related to fears of rejection or abandonment
• Impulsive and potentially self-damaging behavior in areas such as binge eating and purging, alcohol or drug abuse, sexual promiscuity, gambling or spending sprees
Thinking
• Extreme (black or white) thinking
• Difficulty with problem-solving and decision making
• Poor self image and unstable sense of self
• Problems with "detached" thinking, ranging from mild inattention to episodes of complete dissociation
Stages of Treatment
The CCC DBT Program is organized into four stages. Each stage is designed to achieve a set of clearly defined treatment goals. Time spent in any one stage is variable and depends on goal attainment and stabilization.
Stage One: Addresses assessment and preparation. Goals of this stage are to 1) conduct a thorough assessment, 2) provide an orientation to treatment, and 3) establish treatment goals and build commitment to working on them.
Stage Two: Specific behaviors are targeted to increase or decrease. Behaviors to decrease include 1) life-threatening behaviors, 2) behaviors that interfere with progress in treatment, and 3) behaviors that interfere with living a reasonably good quality of life.
Behaviors to increase include 1) dialectical (balanced) thinking and behavior patterns, and 2) adaptive skills in living and relating to others.
Stage Three: Focuses on generalization and maintenance of treatment gains. Specific goals are to 1) refine skills use and encourage application across time and settings, 2) solidify environmental changes to support new behaviors, and 3) increase problem-solving and relapse preventions skills.
Stage Four: Emphasizes developing an increased capacity for joy. Clients engage in more insight-based therapy modalities, such as existential psychotherapy, spiritual direction, or pastoral counseling. Therapy now focuses on issues of meaning, identity and joy.
